Noto Davide, Barbagallo Carlo Maria, Cefalù Angelo Baldassare, Falletta Angelo, Sapienza Michelangelo, Cavera Giovanni, Amato Salvatore, Pagano Michele, Maggiore Maria, Carroccio Antonio, Notarbartolo Alberto, Averna Maurizio R
Department of Clinical Medicine and Emerging Diseases, University of Palermo, Palermo, Italy.
Atherosclerosis. 2008 Mar;197(1):147-53. doi: 10.1016/j.atherosclerosis.2007.03.005. Epub 2007 Apr 26.
The aim of this study was to evaluate the cardiovascular (CV) risk due to the metabolic syndrome in a 15-year prospective study of a Sicilian population. In the Mediterranean area obesity is highly prevalent, but epidemiological data on the metabolic syndrome are limited.
Among the 1351 subjects enrolled in the "Ventimiglia di Sicilia" epidemiological project, we selected 687 subjects between 35 and 75 years of age; baseline parameters were assessed and subjects have been followed for 15 years recording CV events, total and cardiovascular mortality. The metabolic syndrome was defined according to both the Adult Treatment Panel III and the International Diabetes Federation criteria. Metabolic syndrome (ATPIII criteria) was significantly (p<0.00001) more prevalent in women (31.5%) than in men (12.4%). The metabolic syndrome increased the risk of CV events with a hazard ratio of 1.9 (confidence interval CI; 1.46-2.46). Using a Cox proportional hazards estimation model, the survival curve of subjects with metabolic syndrome and normal fasting glucose did not significantly differ from the curve of subjects with metabolic syndrome and impaired fasting glucose (IFG).
In a 15-year follow-up the metabolic syndrome is predictive of CV events regardless of the presence of IFG or diabetes mellitus.
本研究的目的是在一项对西西里人群的15年前瞻性研究中评估代谢综合征所致的心血管(CV)风险。在地中海地区,肥胖非常普遍,但关于代谢综合征的流行病学数据有限。
在“西西里岛文蒂米利亚”流行病学项目纳入的1351名受试者中,我们选取了687名年龄在35至75岁之间的受试者;评估了基线参数,并对受试者进行了15年的随访,记录心血管事件、全因死亡率和心血管死亡率。代谢综合征根据成人治疗小组第三次报告(ATPIII)和国际糖尿病联盟的标准进行定义。代谢综合征(ATPIII标准)在女性(31.5%)中的患病率显著高于男性(12.4%)(p<0.00001)。代谢综合征使心血管事件风险增加,风险比为1.9(置信区间CI:1.46 - 2.46)。使用Cox比例风险估计模型,代谢综合征且空腹血糖正常的受试者的生存曲线与代谢综合征且空腹血糖受损(IFG)的受试者的曲线无显著差异。
在15年的随访中,无论是否存在空腹血糖受损或糖尿病,代谢综合征均可预测心血管事件。